Background: Hirsutism is an important array of clinical syndrome that ranges from various dermatological to gynecological concerns. This is characterized by growth terminal hairs in women in male-pattern.

Aim: To compare the efficacy of Nd-YAG laser with adjuvant eflornithine cream versus Nd-YAG laser treatment alone for facial hirsutism in women.

Methods: It was a Randomized Controlled Trial conducted in the Department of Dermatology, Shalamar Hospital, Lahore from 25th February, 2020 to 25th October, 2020. Sampling technique used was probability consecutive sampling. In this study female cases with age 18-40 years with Fitzpatrick type III-IV were enrolled having facial hirsutism for > 6 months and were randomly allocated in two groups A and B. In group A, cases were provided with eflornithine cream to apply on face after cleaning and drying in the form of a thin film only on the treatment area every night.

Results: A total 162 cases (81 in each group) were enrolled in this study. Mean age of the subjects in group B and A was 30.23±5.43 vs 30.94±4.88 years. Efficacy was observed in 64(79.01%) cases in group B managed with ND-Yag laser alone and 78(96.30%) cases in group A managed with ND-Yag laser along with Eflornithine with p=0.001. For age group 30-40 years efficacy in group B was 41(80.39%) cases and in all the 49(100%) cases in group A with p= 0.001.In cases with BMI up to 25 kg/m2 efficacy in group B and A was observed in 44(88%) vs 49(100%) cases (p=0.03) and those with BMI more than this, this efficacy was found in 20(64.52%) and 29(90.63%) cases respectively with p=0.02.

Conclusion: Efficacy in facial hirsutism is significantly better in ND-Yag laser combined with Eflornithine as compared to ND-Yag laser alone and this difference is also significantly better for combination group in terms of age group 30-40 years, BMI up to 25mg/m2 and in those with duration of complaint upto 2 years.

Keywords: Hirsutism, Efficacy, Eflornithine, Nd-YAG laser